<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500316980
Report Date: 06/03/2022
Date Signed: 06/03/2022 01:28:21 PM


Document Has Been Signed on 06/03/2022 01:28 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:TUOLUMNE HEAD STARTFACILITY NUMBER:
500316980
ADMINISTRATOR:NUNES, HEIDIFACILITY TYPE:
850
ADDRESS:707 HERNDON RDTELEPHONE:
(209) 574-8442
CITY:MODESTOSTATE: CAZIP CODE:
95351
CAPACITY:45CENSUS: 0DATE:
06/03/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Kimbra DraperTIME COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 06/03/2022 Licensing Program Analyst (LPA) Araceli Gibson conducted a tele-inspection via (facetime) with Coordinator, Kimbra Draper of Tuolumne Head Start due to a plumbing crew hitting a sewer line at the facility. Kimbra requested to stay operational during the repair period. Tele-inspection conducted after school hours with no children present.

Purpose of today's (facetime) inspection is to conduct an inspection to stay in compliance with the ratio of children to accessible bathrooms to daycare children. Kimbra Draper is requesting to continue to operate from today’s date Friday, 06/03/22 through Friday, 06/10/22 to repair the plumbing issue. LPA Gibson conducted a virtual tour of the Transitional Kindergarten restrooms on campus for temporary use. The Transitional Kindergarten is located in classroom 27 there are two single restrooms one for staff and one for daycare children with sinks for handwashing located outside of the restroom. LPA observed all working toilets, sinks with working facets. Daycare children are to be supervised by teachers and walked over when restrooms are to be used. Restrooms are cleaned and supplied by custodians daily. Currently there are 20 children enrolled with the alternate restroom the head start will remain in compliance. Both Preschool room 29 and Transitional Kindergarten room 27 restrooms are located kiddie corner from the head start classroom a short walking distance. School is out for the summer and there are no kindergarten children present. Use of the preschool classroom restrooms are still open and also available. In addition, a facility map and layout of the campus will also be submitted for review by the LPA. The Transitional Kindergarten bathrooms are deemed safe and available for day care use beginning 06/03/22 and expires on 06/11/22.

Per California Code of Regulations Title 22 Division 12 Chapter 1, no deficiency is being cited. Notice of Site Inspection to be posted for 30 days was emailed to Kimbra Draper.

A copy of the report was emailed and requested to be returned with signature.

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1